Conjoined twins in Edo state of Nigeria; a report of the first surviving set

The term conjoined twins refers to babies who are physically joined at some point. It is a rare condition with an estimated incidence of 1 per 200,000live births. We report our experience with conjoined twins over a twelve year period in tertiary hospital in Nigeria and a case of the first set of conjoined twin survivors in Benin City, Nigeria. Over the last twelve years  (1999-2011), three cases of conjoined twin have been recorded in our teaching hospital. A set of thoracoomphalopagus twins (females) were delivered in 1999 and they survived for only 36hrs. Another set of female omphalopagus twins were delivered in 2009 and survived a separation surgery. A third set of female thoracoomphalopagus was delivered in another institution same year and referred to our unit but they only survived for 48 hours. The first surviving twins were omphalopagus, sharing a single liver, and common bile duct emptying into a common duodenum. The stomach, as well as the jejunum was normal and unshared. Surgicalseparation of the liver was done and biliary reconstruction procedure performed for twin II. A three -year follow up showed good outcome

Awareness of childhood pneumonia in Benin City, Nigeria

Background: Mortality from pneumonia can be prevented by prompt recognition of symptoms of pneumonia by caregivers at home and appropriate seeking for medical care in a health facility. Active participation in pneumonia control by caregivers is dependent on the extent to which the members of the community are aware of  features of pneumonia and recognising that the child needs medical attention.Objective: To document the knowledge of community members about pneumonia using traders (market women and men in a popular market in Benin City, Nigeria).Design: A descriptive cross-sectional study.Setting: Edaiken market, Benin City, Nigeria.Subjects: All traders, women and men in Edaiken market Benin City Nigeria.Results: Of the 1374 respondents, 1220(88.8%) about pneumonia. Of these 1220, 57.9% correctly identified that pneumonia affects the lungs and exposure to breeze was the risk factor of pneumonia (86.7% of respondents). Knowledge score for  pneumonia was generally low with most respondents 1140(93.5%) scoring < 10 (Poor); and 79(6.5%) had scores 10 – 14 (Fair). Only one person (0.1%) had a score ≥ 15 (Good knowledge). Married individuals were five times more likely to have fair knowledge of pneumonia when compared to the unmarried individuals (OR = 5.0, p = 0.01). Also statistical significant proportion of respondents with presence of an under-five year old in the household had fair knowledge of childhood pneumonia when compared with household with no child younger than five years (p = 0.00).Conclusion: General knowledge of the traders in Benin City about childhood pneumonia was poor. There is need for improved public awareness on childhood pneumonia in this community

Traders’ Perception of Cooking Smoke as a Risk Factor for Childhood Pneumonia

Background: Childhood pneumonia is the foremost killer of under-fives. Indoor air pollution by smoke from cooking fuel is a major risk factor for childhood pneumonia. The knowledge of caregivers about risk factors can facilitate the practice of appropriate preventive measures. This study set out to evaluate the perception of traders about cooking smoke as a risk factor for childhood pneumonia.Methodology: A researcher administered, questionnaire based, cross-sectional study was carried out at a major market in Benin City prior to a market rally to celebrate World Pneumonia Day 2014. The respondents were traders. Information on biodata, place of cooking, fuel for cooking and presence of under-fives in the cooking area of homes of respondents was sought.Results: There were 1374 respondents of which 1192(88.5%) were females. Only 67(4.9%) respondents considered smoke from cooking fuel a risk factor for pneumonia while 99(7.2%) considered avoidance of smoke as a method for preventing pneumonia. Firewood (biomass fuel) was utilized by 272(19.8%) respondents. Respondents with no education were significantly more likely to use firewood (p<0.000). All respondents with under-fives reported having them in the cooking area. Having a child who had suffered pneumonia in the past was not significantly associated with knowing that smoke was a risk factor for childhood pneumonia p>0.05.Conclusion: There is poor awareness of smoke as a risk factor for childhood pneumonia while the use of unclean fuel is significant. As part of health education on childhood pneumonia, smoke as a risk factor should be emphasized. Government should make cleaner fuels more available, accessible and affordable.Keywords: Traders, Cooking Smoke, Ris

Measuring newborn foot length to identify small babies in need of extra care: a cross sectional hospital based study with community follow-up in Tanzania

BACKGROUND\ud \ud Neonatal mortality because of low birth weight or prematurity remains high in many developing country settings. This research aimed to estimate the sensitivity and specificity, and the positive and negative predictive values of newborn foot length to identify babies who are low birth weight or premature and in need of extra care in a rural African setting.\ud \ud METHODS\ud \ud A cross-sectional study of newborn babies in hospital, with community follow-up on the fifth day of life, was carried out between 13 July and 16 October 2009 in southern Tanzania. Foot length, birth weight and gestational age were estimated on the first day and foot length remeasured on the fifth day of life.\ud \ud RESULTS\ud \ud In hospital 529 babies were recruited and measured within 24 hours of birth, 183 of whom were also followed-up at home on the fifth day. Day one foot length <7 cm at birth was 75% sensitive (95%CI 36-100) and 99% specific (95%CI 97-99) to identify very small babies (birth weight <1500 grams); foot length <8 cm had sensitivity and specificity of 87% (95%CI 79-94) and 60% (95%CI 55-64) to identify those with low birth weight (<2500 grams), and 93% (95%CI 82-99) and 58% (95%CI 53-62) to identify those born premature (<37 weeks). Mean foot length on the first day was 7.8 cm (standard deviation 0.47); the mean difference between first and fifth day foot lengths was 0.1 cm (standard deviation 0.3): foot length measured on or before the fifth day of life identified more than three-quarters of babies who were born low birth weight.\ud \ud CONCLUSION\ud \ud Measurement of newborn foot length for home births in resource poor settings has the potential to be used by birth attendants, community volunteers or parents as a screening tool to identify low birth weight or premature newborns in order that they can receive targeted interventions for improved survival

Neonatal seizures in a rural Kenyan District Hospital: aetiology, Incidence and outcome of hospitalization

<p>Abstract</p> <p>Background</p> <p>Acute seizures are common among children admitted to hospitals in resource poor countries. However, there is little data on the burden, causes and outcome of neonatal seizures in sub-Saharan Africa. We determined the minimum incidence, aetiology and immediate outcome of seizures among neonates admitted to a rural district hospital in Kenya.</p> <p>Methods</p> <p>From 1^stJanuary 2003 to 31^stDecember 2007, we assessed for seizures all neonates (age 0-28 days) admitted to the Kilifi District Hospital, who were resident in a defined, regularly enumerated study area. The population denominator, the number of live births in the community on 1 July 2005 (the study midpoint) was modelled from the census data.</p> <p>Results</p> <p>Seizures were reported in 142/1572 (9.0%) of neonatal admissions. The incidence was 39.5 [95% confidence interval (CI) 26.4-56.7] per 1000 live-births and incidence increased with birth weight. The main diagnoses in neonates with seizures were sepsis in 85 (60%), neonatal encephalopathy in 30 (21%) and meningitis in 21 (15%), but only neonatal encephalopathy and bacterial meningitis were independently associated with seizures. Neonates with seizures had a longer hospitalization [median period 7 days - interquartile range (IQR) 4 to10] -compared to 5 days [IQR 3 to 8] for those without seizures, <it>P </it>= 0.02). Overall, there was no difference in inpatient case fatality between neonates with and without seizures but, when this outcome was stratified by birth weight, it was significantly higher in neonates ≥ 2.5 kg compared to low birth weight neonates [odds ratio 1.59 (95%CI 1.02 to 2.46), <it>P </it>= 0.037]. Up to 13% of the surviving newborn with seizures had neurological abnormalities at discharge.</p> <p>Conclusion</p> <p>There is a high incidence of neonatal seizures in this area of Kenya and the most important causes are neonatal encephalopathy and meningitis. The high incidence of neonatal seizures may be a reflection of the quality of the perinatal and postnatal care available to the neonates.</p

Anthropometric cranial measurements of normal newborn in Sergipe - Northeast of Brazil

O estudo antropométrico do crânio é fundamental para a avaliação do recém-nascido. As medidas antropométricas usadas na atualidade são baseadas em resultados obtidos há mais de cinco décadas, os quais não são capazes de determinar um padrão nacional em decorrência de possíveis influências de algumas etnias. Realizamos estudo descritivo analítico em uma Maternidade em Aracaju-SE, com medidas de perímetro cefálico, distancia biauricular e anteroposterior, índice cefálico e medida da fontanela; foram examinadas 450 recém-nascidos com idade gestacional entre 37 e 42 semanas; 49,3% era do gênero masculino e 50,6% do feminino. O perímetro cefálico variou entre 30,0 cm e 39,8 cm com média de 34,14±2,48 com P50 34 cm. O índice cefálico variou entre 0,69 e 1,13 com média de 0,98±0,06 com P50 1. Foi feito uma comparação entre os estudos estrangeiros e brasileiros; o recém-nascido sergipano aproxima-se mais dos resultados obtidos nos estudos da região sudeste do que dos resultados da região nordeste, geograficamente semelhante. A possibilidade de influencias étnicas foi levantada, como também a necessidade de realizar um estudo multicêntrico para criar um perfil antropométrico do recém-nascido brasileiro. _________________________________________________________________________________________ ABSTRACT: The anthropometric mesureaments of the skull is essential for the evaluation of the newborn. The anthropometrics measureaments utilized at the present time are based in the results obtained for more than five decades, which are not able to determine a national pattern mostly likely due to some ethnic influences. We carried out an analytical descriptive study in a maternity hospital in Aracaju-Sergipe, Northeast of Brazil. Measurements of cephalic perimeter, biauricular and anteroposterior distances, cephalic index and fontanels were obtained from 450 newborns with gestacional age from 37 and 42 weeks; 49.3% were male and 50.6% female. The cephalic perimeter ranged from 30.0 cm to 39.8 cm with mean value of 34.14±2.48 P50 34 cm, and cephalic index ranged from 0.69 and 1.13 with mean value of 0.98±0.06 P50 1. A comparison was made between brazilian and foreign studies; the results of the newborn from Sergipe were closer to results obtained in the southeast region than the ones obtained in the northeast region itself. The possibility of ethnical influences was raised as well as the need to design a multicentric study in order to define an anthropometric profile of the brazilian newborn

Is age at commencement of infant immunization a significant determinant of uptake in Nigeria?

Various studies have identified different factors as determinants of immunization uptake. This study set out to evaluate effect of the age at commencement of immunization on immunization uptake in Nigerian children. A retrospective review of data collected during an immunizationcoverage survey using standard WHO/EPI two stage cluster sampling technique. Only 68(54.0%) of 126 children commenced immunization in the first two weeks of life. Of these, 86.8% completed their immunization compared to 57.5% of those who commenced immunization after 28days oflife. This difference was significant (